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Optum Behavioral Health credentialing: Provider Express, tax ID changes and adding networks

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Short answer

  • Optum runs UnitedHealthcare's behavioral health network, including UnitedHealthcare Community Plan of Virginia (Medicaid). You join and manage it through Provider Express.
  • A tax ID change can move only some networks. Ours moved Medicare and the Virginia dual plan but left the commercial networks on the old tax ID.
  • To add networks, send a signed letter of request to Optum Network Management and get a case number. Allow 30 to 45 days.

Check your networks by tax ID

In Provider Express, My Networks lists each network you're in under each tax ID, with its start date. Look at every tax ID on your account. After a tax ID change for a practice we work with, the new tax ID had only Medicare and the Virginia dual special needs plan. UBH General (commercial), the MAMSI plans, Oscar and the Virginia Exchange stayed under the old one, so commercial claims under the new tax ID could deny.

Changing the tax ID

Clinicians with an individual Optum contract use Optum's online Clinician Tax ID Add/Update Form. Reps may call it the "CCF". After you submit it, Optum's Network Participation Request page shows each stage, ending in "Process Complete". Your participation ID is usually your individual NPI.

Adding networks with a letter of request

  1. Write a letter on practice letterhead asking Optum to add the networks you need (for example UBH General, MAMSI, Oscar and UnitedHealthcare Community Plan of Virginia) to the group. Include the individual and group NPIs, tax ID, Medicaid ID, address, phone and email.
  2. Have the clinician sign it and attach a signed W-9.
  3. Call Optum Network Management at 1-877-614-0484 and say "credentialing".
  4. Ask the rep for an email address and send the letter while they're on the line. Ask them to confirm receipt and give you a case number.
  5. Expect 30 to 45 days. Call back with the case number if you hear nothing.

The first time, a rep gave us an email address and we sent the letter afterward. Optum later had no record of it. The second time we sent it during the call and got a case number on the spot.

Good to know

  • The Virginia Exchange network can't be added on request. Optum told us the state reviews it once a year.
  • Check Optum's provider record for errors, such as a nurse practitioner listed as a board-certified physician. Send corrections in writing.
  • Call Network Management on a weekday before 4 PM Central time.

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